CMS Price Transparency Data

Blood transfusion

Facility: Massac Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $987
Cash Discount Price: $1,280
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Massac Memorial Hospital is $987. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,280. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.19x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$1,280

Average discount available for prompt cash payment at this facility.

Insurance Median

$987

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)

Cash / Self-Pay: $1,280 (284%)

Insurance Median: $987 (219%)

Cash: $1,280 (284% of Medicare)

Ins. Median: $987 (219% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 219% of the Medicare baseline (a markup of 119%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$442 - $1,930	98%
Aetna	$468 - $1,644	104%
Health Alliance Mcare Adv	$468 - $1,065	104%
Humana	$468 - $1,065	104%
Health Alliance Exchange	$486 - $1,106	108%
Health Alliance-All Other Plans	$486 - $1,106	108%
Prime Health Services-All Plans	$574 - $1,306	127%
Healthlink Hmo	$647 - $1,473	144%
Healthlink Ppo-All Other Plans	$726 - $1,652	161%
Cigna	$728 - $1,656	162%
UnitedHealthcare	$742 - $1,688	165%
Multiplan-All Plans	$795 - $1,809	176%
Medicaid / KanCare	$907	201%
Molina Ky Mcaid	$907	201%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,280.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Massac Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 36430.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.